THE following statement was made by Antoni Van Leeuwenhoek, the man who discovered the existence of bacteria, blood cells and human semen on a microscope, which incidentally he invented himself more than 300 years ago.

“ I am in the habit of rubbing my teeth with salt in the morning, then rinsing my mouth with water, and often after eating to clean my back teeth with a toothpick as well as rubbing them hard with a cloth, wherefore my teeth, back and front, remain as clean and white that only a few people of my age of 51 years can compare. Also, when I rub my gums with hard salt, they will not bleed.”

Even before there were dentists or toothbrushes, this Dutch biologist and inventor recognised the relationship between oral hygiene and periodontitis (gum disease).
Bleeding on brushing is the well-accepted and primary sign of gum disease. While texts describe the difference between health and disease in the gums based on colour, texture, shape and adhesion to the tooth, and the position of the gums on the teeth, these are very subjective signs, difficult for a patient in a poorly lit home environment to observe, and also quite subjective for the health professional. The absence of bleeding is in most instances a sign of health, although it is acknowledged that deep pocketing between the tooth and gum in advanced gum disease will not demonstrate bleeding on brushing, unless there is superimposed gingivitis.

The cooperation and compliance of patients and the degree to which they make use of tooth-cleaning skills seem to be affected by a number of factors beyond the control of the dental profession. Self-involvement of the patient in the instructional process seems to be the most effective method of achieving long-term improvement in oral health care. When studying motives for seeking preventive care, one tends to focus on four factors in motivation: belief in susceptibility, seriousness, the effectiveness of activities and the importance of dental problems as predictors in involvement in the management of health care, particularly when considering brushing habits. Only a small number of persons see themselves capable of suffering from gum disease because of it being a chronic condition.

The majority of people have a toothbrush and use it at least once a day, which is sufficient to satisfy personal beauty, if not to prevent disease. Therefore, it is not enough to tell people to clean their teeth more regularly, rather, the focus must be the specifics of tooth cleaning and the way one can recognise the productiveness of this process. By far the best way to prevent tooth decay and gum disease is to obey the triple-one method. This formula advocates that ONE minute should be spent cleaning ONE tooth in ONE day. In other words, if a person has 28 teeth, he should spend at least a total of 28 minutes every 24 hours in brushing and flossing etc.

Bleeding is a fearful thing for many people, but demonstration by the dentist will show that this is a sign of disease which in most cases can be overcome by simple measures. Timing and the mechanics of cleaning can be assisted by the dentist (or dental nurse) who can help the patient to find the right techniques for brushing, flossing and gum massaging.

The contemporary patient has come to accept that a reasonable level of personal responsibility is necessary for his well-being. Achievement and maintenance of health are seen as a cooperative programme between the individual and the health care provider. The modern preventive regimen includes abstaining from unhealthy practices, as well as practising those measures which are thought to improve personal health.